Oral Surgery Referral Form Template

General dentists, pediatric dentists, orthodontists referring out for impacted canines, periodontists handing off complex extractions, hygienists flagging suspicious lesions for biopsy, dental front-desk coordinators managing outbound referrals, and oral surgery practices that want a clean intake channel from their referring network.

Most oral surgery referrals still move by fax or by a PDF stapled together from three different programs. That works until a CBCT file is too big to email, or the referring dentist's printer eats the second page, or the patient calls the surgeon's office and nobody can find the chart. A shareable form removes all of that — every referring practice opens the same link, fills out the same fields, and the surgeon's team works from one consistent record. This template is a starting point, not a final draft. Open it in FlexForm and describe what you want changed in plain English — "add a field for the referring dentist's NPI" or "make insurance required for implant consults" — and the AI updates the form for you. Submissions can post to Slack the moment they arrive, drop into a Google Sheet your scheduler already lives in, or trigger a webhook into your practice management software. Share it with referring offices as a simple link, no account or install required on their side. If your surgery practice has its own patient app, the same form embeds inside it through FlexForm's Kotlin Multiplatform mobile SDK — one form, native on both Android and iOS. And the free forever plan covers most single-location practices without ever asking for a credit card.